Demodex Eye Infestation Risk Factors

Age-Related Risk Factors

• Older patients are particularly susceptible to Demodex blepharitis, with a positive correlation between advancing age and risk of infestation 1
• Children have much lower rates of Demodex infestation, with only 12% of healthy children showing evidence of Demodex mites 1

Ocular Surface Conditions

• Dry eye disease is frequently associated with Demodex infestation 1
• Meibomian gland dysfunction (MGD) is commonly seen with Demodex blepharitis 1, 2
• Patients with recalcitrant or treatment-resistant blepharitis often have underlying Demodex infestation 1

Clinical Indicators of Demodex Infestation

• Cylindrical dandruff or sleeves at the eyelash base are pathognomonic signs of ocular Demodex infestation 1
• Severity of ocular surface discomfort strongly correlates with the number of Demodex mites per eyelash 1

Systemic and Medication-Related Factors

• Isotretinoin use is associated with increased colonization of the conjunctiva with S. aureus and blepharitis, which may create conditions favorable for Demodex proliferation 3
• Dupilumab (used for atopic dermatitis) is associated with conjunctivitis, keratitis, and blepharitis in 32-55% of patients, potentially creating conditions for Demodex proliferation 3